State Consumer Disputes Redressal Commission
Rakesh Kumar Mishra vs Dr R C Singh on 23 August, 2022
Cause Title/Judgement-Entry STATE CONSUMER DISPUTES REDRESSAL COMMISSION, UP C-1 Vikrant Khand 1 (Near Shaheed Path), Gomti Nagar Lucknow-226010 Complaint Case No. C/2001/88 ( Date of Filing : 04 May 2001 ) 1. Rakesh Kumar Mishra a ...........Complainant(s) Versus 1. Dr R C Singh a ............Opp.Party(s) BEFORE: HON'BLE MR. Rajendra Singh PRESIDING MEMBER HON'BLE MR. SUSHIL KUMAR JUDICIAL MEMBER PRESENT: Dated : 23 Aug 2022 Final Order / Judgement (सुरक्षित) राज्य उपभोक्ता विवाद प्रतितोष आयोग , उ0प्र0 , लखनऊ परिवाद संख्या-88/2001 राकेश कुमार मिश्र पुत्र श्री राम अधार मिश्र, आरक्षी संख्या-सी.पी. 517, थाना भीरा, जिला लखीमपुर खीरी, उत्तर प्रदेश पुलिस, मूल निवासी ग्राम रूदापुर मजरे महुआर थाना कोतवाली नगर, जनपद प्रतापगढ़ (उ0प्र0)। परिवादी बनाम 1. डा0 आर0सी0 सिंह, एम0एस0 सर्जरी, भू0पी0 सीनियर सर्जन, जिला अस्पताल लखीमपुर खीरी, बैसवारा नर्सिंग होम, थाना कोतवाली लखीमपुर खीरी उ0प्र0। 2. मालिक/स्वामी बैसवारा नर्सिंग होम, थाना कोतवाल, लखीमपुर खीरी उत्तर प्रदेश। विपक्षीगण समक्ष:- 1. माननीय श्री राजेन्द्र सिंह, सदस्य। 2. माननीय श्री सुशील कुमार, सदस्य। परिवादी की ओर से उपस्थित : श्री सुशील कुमार शर्मा, विद्वान अधिवक्ता। विपक्षीगण की ओर से उपस्थित : श्री एम0एच0 खान, विद्वान अधिवक्ता। दिनांक: 09.06.2022 माननीय श्री सुशील कुमार , सदस्य द्वारा उद्घोषित निर्णय 1. यह परिवाद, विपक्षीगण के विरूद्ध इलाज के दौरान सेवा में कमी के आधार पर अंकन 12,50,000/- रूपये की क्षतिपूर्ति प्राप्त करने के लिए तथा परिवाद व्यय प्राप्त करने के लिए प्रस्तुत किया गया है। 2. परिवाद के तथ्य संक्षेप में इस प्रकार हैं कि परिवादी उत्तर प्रदेश पुलिस विभाग में आरक्षी के पद पर लखीमपुर खीरी में तैनात है। दिनांक 17.07.2000 की रात्रि में पेट में पीड़ा के कारण वह इलाज हेतु बैसवारा नर्सिंग होम में भर्ती हुआ। डा0 आर.सी. सिंह ने परिवादी के पेट का एक्स-रे लिया और परिवादी की आंत में सुराक होना बताया तथा जान बचाने के लिए आपरेशन करना बताया। अंकन 30,000/- रूपये तत्काल फीस जमा कराई बाकी पैसे बाद में देने के लिए कहा। 12 दिनों तक अस्पताल में भर्ती रखा गया। दिनांक 29.07.2000 को डिसचार्ज किया गया। डा0 की सलाह पर 45 दिन का चिकित्सीय अवकाश लिया गया। परिवादी आपरेशन से स्वस्थ नहीं हुआ और दर्द बड़ता गया बाद में परिवादी ने डा0 आर.के. सिंह तथा डा0 घनश्याम अग्रवाल को दिखाया। दिनांक 03.10.2000 को अल्ट्रासाउण्ड की सलाह दी गई। अल्ट्रासाउण्ड कराने की रिपोर्ट दोनों डाक्टरों को दिखाई गई तब उन्होंने आपरेशन की सलाह दी। मोतीलाल नेहरू मेडिकल कालेज के पूर्व निदेशक डा0 ए0के0 गुप्ता को भी दिखाया गया, उनके द्वारा भी अल्ट्रासाउण्ड, खून एवं पेशाब की जांच कराने के लिए कहा गया और रिपोर्ट देखने के बाद पुन: आपरेशन की सलाह दी गई। दिनांक 20.12.2000 को परिवादी का पुन: आपरेशन किया गया और यह पाया गया कि डा0 सिंह द्वारा प्रयोग की गई सर्जिकल स्पंच (तौलिया) पेट में ही छूट गई, जो विपक्षी संख्या-1 की लापरवाही का द्योतक है, इसलिए क्षतिपूर्ति के लिए वाद प्रस्तुत किया गया। 3. परिवादी ने परिवाद पत्र के समर्थन में अपना शपथपत्र प्रस्तुत किया तथा इलाज से संबंधित दस्तावेज प्रस्तुत किए गए। अल्ट्रासाउण्ड की रिपार्ट भी प्रस्तुत की गई। सुसंगत दस्तावेजों का उल्लेख आगे चलकर किया जाएगा। 4. विपक्षीगण की आपत्ित के अनुसार सर्जिकल स्पंच को सुरक्षित नहीं रखा गया। परिवादी ने दिनांक 28.01.2001 को प्रथम सूचना रिपोर्ट दर्ज कराई गई, जिसके आधार पर अपराध संख्या-250/2001 धारा 269 एवं 337 आईपीसी पंजीकृत हुआ। विवेचना के दौरान मेडिकल कालेज लखनऊ के प्रींसिपल द्वारा एक बोर्ड का गठन किया गया, जिनके द्वारा दिनांक 29.06.2001 को रिपोर्ट दी गई। इस रिपोर्ट के आधार पर विवेचनाधिकारी ने यह निष्कर्ष दिया कि इतनी लम्बाई का सर्जिकल स्पंच पेट में छोड़ना संभव नहीं है, इसलिए कोई अपराध होना नहीं पाया गया। परिवादी ने अंतिम रिपोर्ट पर सीजेएम के समक्ष आपत्ति प्रस्तुत की। सीजेएम द्वारा भी यही निष्कर्ष दिया गय। दिनांक 08.11.2000 को अल्ट्रासाउण्ड रिपोर्ट में भी जो प्रीति हॉस्पिटल में तैयार की गई है, सर्जिकल स्पंच होना नहीं पाया गया, इसलिए चूंकि एक बार मुख्य न्यायिक मजिस्ट्रेट लखीमपुर खीरी द्वारा विवेचना पर निष्कर्ष दिया जा चुका है, इसलिए पुन: उन्हीं तथ्यों पर नया परिवाद पोषणीय नहीं है। इस आपत्ति के साथ मुख्य न्यायिक मजिस्ट्रेट द्वारा अंतिम रिपोर्ट पर पारित आदेश की प्रति, विवेचनाधिकारी द्वारा तैयार दस्तावेजों की प्रतियां प्रस्तुत की गई। 5. दोनों पक्षकारों के विद्वान अधिवक्ताओं को सुना गया तथा पत्रावली का अवलोकन किया गया। 6. प्रस्तुत केस में इस परिवाद के निस्तारण के लिए इस पीठ को केवल इस बिन्दु पर निष्कर्ष देना है कि क्या प्रथम आपरेशन के समय विपक्षी संख्या-1 द्वारा सर्जिकल स्पंच पेट में भूलवश छोड़ दिया गया था, जिसके कारण परिवादी को शारीरिक, मानसिक एवं आर्थिक प्रताड़ना कारित हुई, जिसकी क्षतिपूर्ति के लिए विपक्षी संख्या-1 एवं 2 एकल तथा संयुक्त रूप से उत्तरदायी हैं ? 7. दोनों पक्षकारों के विद्वान अधिवक्ता इस तथ्य को स्वीकार करते हैं कि विपक्षी संख्या-1 द्वारा परिवादी का प्रथम आपरेशन किया गया। अत: प्रथम आपरेशन के संबंध में निष्कर्ष देने की आवश्यकता है। प्रथम आपरेशन करने के पश्चात परिवादी द्वारा पेट में दर्द की शिकायत बनी रहने पर डा0 की सलाह पर पुन: अल्ट्रासाउण्ड मिश्रा अल्ट्रासाउण्ड सेण्टर, प्रतापगढ़ में कराया, जिसकी रिपोर्ट पत्रावली पर मौजूद है। पेट में मौजूद पदार्थ के संबंध में निम्नलिखित उल्लेख है :- "Fibrous beeds adhering between the bowel loops in right lower pelvis (Appendicular Area) with some amount of fluid collection seen around it suggestive of inflamentory signs." 8. प्रीति मेडिकल रिसर्च एण्ड चैरिटेबल ट्रस्ट, इलाहाबाद (प्रयागराज) द्वारा जो रिपोर्ट प्रस्तुत की गई है, वह रिपोर्ट BIO Chemical Examination से संबंधित रिपोर्ट है, इस रिपोर्ट के अनुसार खून का सैम्पल लेकर विभिन्न प्रकार के परीक्षण किए गए और उनकी रिपोर्ट तैयार की गई। इस रिपोर्ट को तैयार करने से पहले अल्ट्रासाउण्ड नहीं किया गया, इसलिए यह रिपोर्ट मिश्रा अल्ट्रासाउण्ड सेण्टर की रिपोर्ट को असत्य साबित नहीं करती। दूसरा आपरेशन करते समय की गई फोटोग्राफी के अनुसार मरीज के पेट से सर्जिकल स्पंच निकला है, इस तथ्य की रिपोर्ट अखबारों में प्रकाशित हुई है। यहां यह उल्लेख करना समीचीन होगा कि उपभोक्ता परिवाद पर निष्कर्ष देने के उद्देश्य से भारतीय साक्ष्य अधिनियम के सिद्धान्त दृढता के साथ लागू नहीं होते। अत: शपथपत्र से पुष्टि की गई इस रिपोर्ट को भी विचार में लिया जा सकता है। 9. दस्तावेजों के अवलोकन से यह स्थिति स्पष्ट होती है कि विपक्षी संख्या-1 के विरूद्ध आपराधिक वाद पंजीकृत हुआ, विवेचना की गई, विवेचना के पश्चात अंतिम रिपोर्ट प्रस्तुत की गई। विपक्षीगण के विद्वान अधिवक्ता का यह तर्क है कि विवेचनाधिकारी द्वारा विवेचना के दौरान मेडिकल बोर्ड की रिपोर्ट को विचार में लिया गया है और मेडिकल बोर्ड द्वारा यह रिपोर्ट दी गई है कि जिस लम्बाई का सर्जिकल स्पंच द्वितीय आपरेशन के समय पेट से निकालना बताया गया है, उस लम्बाई चौडाई का स्पंच पेट के अन्दर नहीं रह सकता। 10. विपक्षीगण के विद्वान अधिवक्ता का यह तर्क मात्र संभावना एवं कल्पना पर आधारित है, क्योंकि मेडिकल बोर्ड की रिपोर्ट उस समय विचार में लेने योग्य हो सकती थी, जब बोर्ड की शिकायत पर मेडिकल बोर्ड द्वारा अपनी देख-रेख में अल्ट्रासाउण्ड कराया गया होता। द्वितीय आपरेशन हो जाने के पश्चात चूंकि सर्जिकल स्पंच पेट में मौजूद नहीं था। अत: इसके पेट में मौजूद न हो सकने की रिपोर्ट केवल एक कयास भर है। यह रिपोर्ट किसी वैज्ञानिक तथ्यों पर आधारित नहीं है। अत: इस रिपोर्ट को विचार में नहीं लिया जा सकता। यह उल्लेख करना भी समीचीन होगा कि मुख्य न्यायिक मजिस्ट्रेट द्वारा दिए गए निष्कर्ष का कोई प्रभाव उपभोक्ता परिवाद पर नहीं है, क्योंकि उपभोक्ता परिवाद एक स्वतंत्र कार्यवाही है और किसी अन्य कानून के अन्तर्गत दिए गए निष्कर्ष पर उपभोक्ता परिवाद के निस्तारण का आधार नहीं बनाया जा सकता। 11. नजीर Achutrao haribhau khodwa and others vs State of Maharashtra and others (1996) 2 supreme court cases 634 में व्यवस्था दी गई है कि यदि पेट के अन्दर मोप छोड़ दिया गया है तब माना जाएगा कि चिकित्सक की लापरवाही स्वंय में एक प्रमाण है और तदनुसार चिकित्सक क्षतिपूर्ति के लिए उत्तरदायी है। इस नजीर में दी गई व्यवस्था प्रस्तुत केस के लिए पूर्णतया सुसंगत है। साक्ष्य से साबित है कि द्वितीय आपरेशन के समय परिवादी के पेट से सर्जिकल स्पंच निकाला गया है, यह सही है कि उस स्पंच को सुरक्षित रखकर उपभोक्ता आयोग के समक्ष प्रस्तुत नहीं किया गया, परन्तु भौतिक साक्ष्य के बिना भी सर्जिकल स्पंच की पेट से निकासी का तथ्य शपथपत्र एवं डा0 द्वारा तैयार किए गए दस्तावेजों के आधार पर साबित होती है। 12. डा0 आर.सी. सिंह द्वारा अपने शपथपत्र में केवल विवेचनाधिकारी द्वारा तैयार की गई विवेचना और मुख्य न्यायिक मजिस्ट्रेट द्वारा अंतिम रिपोर्ट की स्वीकृति के बिन्दुओं का उल्लेख किया है। डा0 अग्रवाल द्वारा द्वितीय आपरेशन के संबंध में, इस आपरेशन के समय सर्जिकल स्पंच पेट से निकलने के संबंध में कोई शपथपत्र नहीं दिया है। अत: परिवादी द्वारा इस बिन्दु पर शपथपत्र के माध्यम से जो साक्ष्य प्रस्तुत की गई है, वह अखण्डनीय है। 13. उपरोक्त विवेचना का निष्कर्ष यह है कि डा0 द्वारा प्रथम आपेरशन के समय कारित लापरवाही संदेह से परे साबित है, जिसके के लिए परिवादी को मानसिक, शारिरिक एवं आर्थिक प्रताड़ना से गुजरना पड़ा और राजकीय सेवा से लम्बे समय तक वंचित होना पड़ा। अत: परिवादी विपक्षीगण से उनके द्वारा कारित लापरवाही के आधार पर एकल एवं संयुक्त दायित्वों के तहत क्षतिपूर्ति प्राप्त करने के लिए अधिकृत है। 14. परिवादी द्वारा अपने परिवाद पत्र में यह उल्लेख किया गया है कि कुल 12,50,000/- रूपये की क्षतिपूर्ति दिलाई जाए, परन्तु इस राशि का कोई आंकलन नहीं किया गया है। इलाज में आए खर्च का विवरण नहीं प्रस्तुत किया गया। मानसिक प्रताड़ना की मद में प्राप्त होने वाली राशि का स्पष्ट उल्लेख नहीं किया गया है। अत: इस उच्च दर से क्षतिपूर्ति दिलाए जाने का आदेश विधिसम्मत नहीं है, परन्तु केस की परिस्थितियों को दृष्टिगत रखते हुए विपक्षीगण के विरूद्ध अंकन 05 लाख रूपये की क्षतिपूर्ति का आदेश देना विधिसम्मत है तथा परिवाद खर्च के रूप में अंकन 10,000/- रूपये का आदेश देना भी विधिसम्मत है। तदनुसार परिवाद आंशिक रूप से स्वीकार होने योग्य है। आदेश 15. प्रस्तुत परिवाद इस रूप में स्वीकार किया जाता है कि विपक्षीगण एकल एवं संयुक्त दायित्व के तहत परिवादी को अंकन 05 लाख रूपये क्षतिपूर्ति के रूप में इस निर्णय/आदेश के तीन माह के अन्दर अदा करे। इस राशि पर परिवाद प्रस्तुत करने की तिथि से भुगतान की तिथि तक 06 प्रतिशत प्रतिवर्ष की दर से साधारण ब्याज भी देय होगा। परिवाद व्यय के रूप में विपक्षीगण एकल एवं संयुक्त दायित्व के तहत परिवादी को अंकन 10 हजार रूपये उपरोक्त अवधि में अदा करें। इस राशि पर कोई ब्याज देय नहीं होगा। आशुलिपिक से अपेक्षा की जाती है कि वह इस निर्णय/आदेश को आयोग की वेबसाइट पर नियमानुसार यथाशीघ्र अपलोड कर दे। (राजेन्द्र सिंह) (सुशील कुमार) सदस्य सदस्य निर्णय/आदेश आज खुले न्यायालय में हस्ताक्षरित, दिनांकित होकर उद्घोषित किया गया। (राजेन्द्र सिंह) (सुशील कुमार) सदस्य सदस्य लक्ष्मन, आशु0, कोर्ट-2 Complaint no.88 of 2001 Rajesh Kumar Mishra vs. Dr. R.C. Singh & anr. 9.6.2022 JUDGMENT
Per Mr. Rajendra Singh, Member: I have seen the judgment, evidence, pleadings and documents on record.
It is clear that the deficiency in service and extreme carelessness has been established in the case. In this connection following oath taken by the doctors and various articles regarding negligence and case laws shall also be considered.
Now let us see the oath taken be a doctor before entering the nobel profession of the Medical World. As per guidelines of MCI, Every member should get it framed in his or her office it should never be violated in its letter and spirit.
"I solemnly pledge myself to consecrate my life to service of humanity.
Even under threat, I will not use my medical knowledge contrary to the laws of Humanity.
I will maintain the utmost respect for human life from the time of conception.
I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient.
I will practice my profession with conscience and dignity.
The health of my patient will be my first consideration.
I will respect the secrets which are confined in me.
I will give to my teachers the respect and gratitude which is their due.(2)
I will maintain by all means in my power, the honour and noble traditions of medical profession.
I will treat my colleagues with all respect and dignity.
I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.
I make these promises solemnly, freely and upon my honour."
The complexity of the human body and the uncertainty involved in the medical procedure are of such great magnitude that it is impossible for a Doctor to guarantee a successful result; and the only assurance that he can give, or can be understood to have given by implication is that he is possessed of requisite skill in that branch of profession which he is practising and while undertaking the performance of the task entrusted to him, he would be exercising his skills with reasonable competence. An ordinary physician or surgeon is not expected to be either a clodhopper or feckless practitioner of profession, as much as, he is not expected to be a paragon, combining qualities of polymath or prophet as in the realm of diagnosis and treatment, there is ample scope for genuine difference of opinion; and a Doctor cannot be treated as negligent merely because his conclusion differs from that of other persons in the profession, or because he has displayed less skill or knowledge than others would have shown. The true test for establishing negligence in diagnosis or treatment on the part of a doctor is whether he has been proved to be guilty of such failure as no doctor of ordinary skill would be guilty of, if acting with ordinary care. Furthermore, a golden (3) principle of law has been laid down by the Hon'ble Apex Court in Jacob Mathew Vs. State of Punjab, (AIR 2005 SC 3180) that no sensible professional would intentionally commit an act or omission which would result in loss or injury to the patient as the professional reputation of the person is at stake. A single failure may cost him dear in his career. Even in civil jurisdiction, the rule of res ipsa loquitor is not an universal application and has to be applied with extreme care and caution to the cases of professional negligence and in particular that of the doctors, else it would be counter productive. Simply because a patient has not favourably responded to a treatment given by a physician or a surgery has failed, the doctor cannot be held liable per-se by applying the doctrine of res ipsa loquitor. Yet, another golden principle of law has been laid down by the Hon'ble Apex Court in Indian Medical Association Vs. V.P. Santha's III (1995) CPJ 1 (SC) at para 37 that "it is no doubt true that sometimes complicated questions requiring recording of evidence of experts may arise in a complaint about deficiency in service based on the ground of negligence in rendering medical services by a medical practitioner; but this would not be so in all complaints about deficiency rendering services by a medical practitioner. There may be cases which do not raise such complicated questions and the deficiency in service may be due to obvious faults which can be easily established such as removal of the wrong limb or the performance of an operation on the wrong patient or giving injection of a drug to which the patient is allergic without looking into the out patient card containing the warning or use of wrong gas during the course of an (4) anaesthetic or leaving inside the patient swabs or other items of operating equipment after surgery. Furthermore, it has been observed in Malay Kumar Ganguli's case (AIR 2010 SC 1162) that" charge of professional negligence on a medical person is a serious one as it affects his professional statusand reputation and as such, the burden of proof would be more onerous. A doctor cannot be held negligent only because something has gone wrong. He also cannot be held liable for mischance or misadventure or for an error in judgment in making a choice when two options are available. The mistake in diagnosis is not necessarily a negligent diagnosis." In the instant matter, thus a simple test, in the light of aforesaid observations, needs to be conducted in order to ascertain whether the Doctor is guilty of any tortious act of negligence/battery amounting to deficiency in conducting a surgery in the delivery of child and not properly attending the patient, the complainant and consequently, liable to pay damages for leaving cotton mass in the abdomen / stomach due to failure in surgery and deteriorating condition of the patient.
Now, it is required to be seen whether an expert report is necessary in each and every case relating to medical negligence or not ? It has been observed by the Hon'ble Apex Court in Indian Medical Association Vs. V.P. SanthaIII(1995) CPJ 1 (SC) at para 37 that "it is no doubt true that sometimes complicated questions requiring recording of evidence of experts may arise in a complaint about deficiency in service based on the ground of negligence in rendering medical services by a medical practitioner; but this would not be so in all complaints about deficiency (5) rendering services by a medical practitioner. There may be cases which do not raise such complicated questions and the deficiency in service may be due to obvious faults which can be easily established such as removal of the wrong limb or the performance of an operation on the wrong patient or giving injection of a drug to which the patient is allergic without looking into the out patient card containing the warning or use of wrong gas during the course of an anaesthetic or leaving inside the patient swabs or other items of operating equipment after surgery. Furthermore, in B. Krishna Rao Vs. Nikhil Super Speciality Hospital 2010 (V) SCC 513 at para 40 the Hon'ble Apex Court was pleased to hold that it is not necessary to have opinion of the expert in each and every case of medical negligence. The Hon'ble Apex Court was pleased to further hold in Nizam Institute of Medical Sciences Vs. Prashant S. Dhananka and others 2009 (VI) SCC 1 that "in a case of medical negligence, once initial burden has been discharged by the complainant by making of a case of negligence on the part of the hospital or the doctor concerned, the owner then shifts on the hospital or to the attending doctors and it is for the hospital to satisfy the court that there was no lack of care or diligence".
A doctrine or rule of evidence in tort law that permits an inference or presumption that a defendant was negligent in an accident injuring the plaintiff on the basis of circumstantial evidence if the accident was of a kind that does not ordinarily occur in the absence of negligence plaintiff who establishes the elements of res ipsa (6) loquitur can withstand a motion for summary judgment and reach the jury without direct proof of negligence-- Cox v. May Dept. Store Co., 903 P.2d 1119 (1995).
In Byrne vs Boadle, this maxim was used for the first time where the complainant was injured by a barrel that dropped from the window of the defendant. In the abovementioned case, Pollock, C. B., said "here are many incidents from which no presumption of negligence can arise, but this is not true in every case. It is the duty of persons who keep barrels in a warehouse to take care that they do not roll out and I think that such a case will, beyond all doubt, afford prima facie proof of negligence."
This doctrine intends to help direct the court proceedings to a conclusion, especially if it is established through the implication of this doctrine's rule that the injury caused to the claimant would not have occurred or taken place if the defendant wasn't negligent. This also gives enough cause and evidence to hold the defendant liable for his negligent actions.
Essentials of Res Ipsa Loquitur Maxim The injury caused to the plaintiff shall be a result of an act of negligence.
There is a lack of evidence, or the evidence presented before the court is insufficient to establish the possibilities of the fault of the plaintiff or third party.
The defendant owes a duty of care towards the plaintiff, which he has breached.
There is a significant degree of injury caused to the plaintiff.
(7)Applicability of Doctrine of Res Ipsa Loquitur The maxim of res ipsa loquitur came into force to benefit the plaintiff as he can use circumstantial evidence to establish negligence.
Consequently, it shifts the burden of proof on the defendant, logic being, where there is an event of unexplained cause, usually, the one that does not occur without the defendant's negligence in controlling the action which has caused the injury to the claimant or destroyed his goods.
In this scenario, the court shall presume negligence on the part of the defendant in such a case unless it includes an appropriate explanation compatible with his taking reasonable care.
In Achutrao Haribhau Khodwa and Others vs. State of Maharashtra and Others, it was considered that the maxim should not be applied in the case of general incidences of neglect and shall only be reflected when there is a significant degree of injury caused.
Section 106 of the Indian Evidence Act Section 106 of the Act provides that when any fact is especially within the knowledge of any person, the burden of proving that fact is upon him.
Res ipsa loquitur is a Latin phrase that means "the thing speaks for itself." In personal injury law, the concept of res ipsa loquitur (or just "res ipsa" for short) operates as an evidentiary rule that allows plaintiffs to establish a rebuttable presumption of negligence on the part of the defendant through the use of circumstantial evidence.
This means that while plaintiffs typically have to prove that the defendant acted with a negligent state of mind, (8) through res ipsa loquitur, if the plaintiff puts forth certain circumstantial facts, it becomes the defendant's burden to prove he or she was not negligent.
Res Ipsa Loquitur and Evidence Law.
Accidents happen all the time, and the mere fact that an accident has occurred doesn't necessarily mean that someone's negligence caused it. In order to prove negligence in a personal injury lawsuit, a plaintiff must present evidence to demonstrate that the defendant's negligence resulted in the plaintiff's injury. Sometimes, direct evidence of the defendant's negligence doesn't exist, but plaintiffs can still use circumstantial evidence in order to establish negligence.
Circumstantial evidence consists of facts that point to negligence as a logical conclusion rather than demonstrating it outright. This allows judges and juries to infer negligence based on the totality of the circumstances and the shared knowledge that arises out of human experience. Res ipsa is one type of circumstantial evidence that allows a reasonable fact finder to determine that the defendant's negligence caused an unusual event that subsequently caused injury to the plaintiff.
This doctrine arose out of a case where the plaintiff suffered injuries from a falling barrel of flour while walking by a warehouse. At the trial, the plaintiff's attorney argued that the facts spoke for themselves and demonstrated the warehouse's negligence since no other explanation could account for the cause of the plaintiff's injuries.
As it has developed since then, res ipsa allows judges and juries to apply common sense to a situation in order to determine whether or not the defendant acted negligently.
(9)Since the laws of personal injury and evidence are determined at the state level, the law regarding res ipsa loquitur varies slightly between states. That said, a general consensus has emerged, and most states follow one basic formulation of res ipsa.
Under this model for res ipsa, there are three requirements that the plaintiff must meet before a jury can infer that the defendant's negligence caused the harm in question:
The event doesn't normally occur unless someone has acted negligently;
The evidence rules out the possibility that the actions of the plaintiff or a third party caused the injury; and The type of negligence in question falls with the scope of the defendant's duty to the plaintiff.
As mentioned above, not all accidents occur because of someone else's negligence. Some accidents, on the other hand, almost never occur unless someone has acted negligently.
Going back to the old case of the falling flour-barrel, it's a piece of shared human knowledge that things don't generally fall out of warehouse windows unless someone hasn't taken care to block the window or hasn't ensured that items on the warehouse floor are properly stored. When something does fall out of a warehouse window, the law will assume that it happened because someone was negligent.
Top of Form Bottom of Form The second component of a res ipsa case hinges on whether the defendant carries sole responsibility for the (10) injury. If the plaintiff can't prove by a preponderance of the evidence that the defendant's negligence cause the injury, then they will not be able to recover under res ipsa.
States sometimes examine whether the defendant had exclusive control over the specific instrumentality that caused the accident in order to determine if the defendant's negligence caused the injury. For example, if a surgeon leaves a sponge inside the body of a patient, a jury can infer that the surgeon's negligence caused the injury since he had exclusive control over the sponges during the operation.
In addition to the first two elements, the defendant must also owe a duty of care to protect the plaintiff from the type of injury at issue in the suit. If the defendant does not have such a duty, or if the type of injury doesn't fall within the scope of that duty, then there is no liability.
For example, in many states, landowners don't owe trespassers any duty to protect them against certain types of dangers on their property. Thus, even if a trespasser suffers an injury that was caused by the defendant's action or inaction and that wouldn't normally occur in the absence of negligence, res ipsa loquitur won't establish negligence since the landowner never had any responsibility to prevent injury to the trespasser in the first place.
Res ipsa only allows plaintiffs to establish the inference of the defendant's negligence, not to prove the negligence completely. Defendants can still rebut the presumption of negligence that res ipsa creates by refuting one of the elements listed above.
For example, the defendant could prove by a preponderance of the evidence that the injury could occur (11) even if reasonable care took place to prevent it. An earthquake could shake an item loose and it could fall out of the warehouse window, for instance.
A defendant could also demonstrate that the plaintiff's own negligence contributed to the injury. To go back to the flour-barrel example, if the defendant shows that the plaintiff was standing in an area marked as dangerous it could rebut the presumption of negligence created by res ipsa.
Finally, the defendant could establish that he did not owe the plaintiff a duty of care under the law, or that the injury did not fall within the scope of the duty owed. For example, if the law only imposes a limited duty on the defendant not to behave recklessly, then res ipsa will not help the plaintiff by creating an inference of negligence since a negligent action would not violate the duty owed to the plaintiff.
According to the Blacks Law Dictionary the maxim is defined as the doctrine providing that, in some circumstances, the mere fact of accidents occurrence raises an inference of negligence so as to establish a prima facie (at first sight) case. It is a symbol for that rule that the fact of the occurrence of an injury taken with the surrounding circumstances may permit an inference or recipes omission of negligence, or make out a plaintiff's prima facie case and present a question of fact for defendant to meet with and explanation. It is merely a short way of saying that the circumstances attendant on the accident are of such a nature to justify a jury in light of common sense and past experience in inferring that the accident was probably the result of the defendant's (12) negligence, in the absence of explanation or other evidence which the jury believes.
Its use in clinical negligence gained some traction before Bolam and Bolitho. Mahon v Osborne [1939] 1 All ER 535, is an early example of the application of res ipsa loquitur in a case where a surgical swab had been left inside a patient's body.
In Clarke v Worboys (1952) Times, 18 March, CA, a patient noticed burns on her buttock shortly after surgical excision of a breast tumour. The surgery involved cauterisation. The Court of Appeal held that this was a case where res ipsa loquitur applied. The outcome was not one that would ordinarily occur in the absence of negligence, and the surgical team were unable to explain how the injury was caused.
In Cassidy v Ministry of Health [1951] 2 KB 343, Denning LJ succinctly summarised the maxim's application to clinical negligence cases: "I went into hospital to be cured of two stiff fingers. I have come out with four stiff fingers and my hand is useless. That should not happen if due care had been used. Explain it if you can."
Ng Chun Pui Vs Lee Chuen Tat, the first defendant was driving a coach owned by the second defendant westwards in the outer lane of dual carriageway in Hong Kong. Suddenly the course across the central reservation and collided with a public bus travelling in the inner lane of the other carriageway, killing one passenger in the bus and injuring the driver and three others on the bus. The plaintiff could not prove that the defendants were negligent and had caused the accident. They however proceeded on the basis of Res Ipsa (13) Loquitur and shifted the onus on the defendants to prove that they were not negligent. However, they failed to do so. And the judicial committee of the Privy Council held the defendants liable for the plaintiffs injuries. { MarkLuney and Ken Opliphant , Tort Law Text And Materials (Oxford University Press, New York, 2000) pp 173-175 } In A.S. Mittal &Anr Vs State Of UP &Ors , AIR 1979 SC 1570 , the defendants had organised an eye camp at Khurja along with the Lions Club. 88 low risk cataract operations were undertaken during the period of the camp. It was however, disastrous as many of those who had been operated upon lost their eyesight due to post medical treatment. Proceedings against the government initiated for negligence of the doctors. Damages worth ₹ 12,500/- were paid as interim belief to each of the aggrieved. The decision was on the basis of Res Ipsa Loquitur as the injury would not have occurred had the doctors not been negligent in not having followed up with post-operation treatment. Res Ipsa Loquitur can be applied in matters where are the procedures have not been followed and is not just limited to the commission of an act.
We can define 'Medical negligence' as the improper or unskilled treatment of a patient by a medical practitioner. This includes negligence in taking care from a nurse, physician, surgeon, pharmacist, or any other medical practitioner. Medical negligence leads to 'Medical malpractices' where the victims suffer some sort of injury from the treatment given by a doctor or any other medical practitioner or health care professional.(14)
Medical negligence can occur in different ways. Generally, it occurs when a medical professional deviates from the standard of care that is required.
So, we can say that any kind of deviation from the accepted standards of medication and care is considered to be medical negligence and if it causes injury to a patient then the doctor who operated on him, other staff and/or hospital may be held liable for this.
Some of the common categories of medical negligence are as follows:
Wrong diagnosis - When someone goes to a hospital, clinic or medical room, etc. the first step after admittance is the diagnosis. Diagnosing symptoms correctly is critical and important to provide medical care to any patient. However, if a patient is not treated properly due to any mistake in diagnosis, the doctor can be made liable for any further injury or damages caused as a result of the wrong diagnosis.
Delay in diagnosis - A delayed diagnosis is treated as medical negligence if another doctor would have reasonably diagnosed the same condition in a timely fashion. A delay in diagnosis can cause undue injury to the patient if the illness or injury is left to worsen with time rather than being treated. Obviously, any delay in the identification and treatment of an injury can reduce the chance of recovery for the patient.
Error in surgery - Surgical operations require an enormous level of skill and it should be done with due care and caution because even the slightest (15) mistakes can have profound effects on the patient. The wrong-site surgery, lacerations of any internal organ, severe blood loss, or a foreign object being left in the body of the patients, all this comes under Surgical error.
Unnecessary surgery - Unnecessary surgery is usually associated with the misdiagnosis of patient symptoms or a medical decision without proper consideration of other options or risks. Alternatively, sometimes surgery is chosen over conventional treatments for their expediency and ease compared to other alternatives.
Errors in the administration of anesthesia - Anesthesia is a risky part of any major medical operation and requires a specialist (anesthesiologist) to administer and monitor its effect on the patient. Prior to any medical procedure requiring anesthesia, the anesthesiologist has to review the patient's condition, history, medications, etc. to determine the most suitable of all the medicine to use. Anesthesia malpractice can happen even during the pre-operation medical review or during the procedure itself.
Childbirth and labor malpractice - Childbirth is a difficult event for a woman and it becomes worse if not handled properly by the doctors and nurses. There are many instances of medical negligence during childbirth including the mishandling of a difficult birth, complications with induced labor, misdiagnosis of a newborn medical condition, etc. (16) Long-Term negligent treatment - Medical negligence can also occur in subtle ways over the course of a long treatment period. Usually, the negligence can take the shape of a failure to follow up with treatment, or a doctor's failure to monitor the effects of the treatment properly.
A standard of care specifies the appropriate treatment and medication procedure as per the requirements that should be taken into account by a doctor while providing the treatment to his patients. The care should not be of the highest degree nor the lowest.
Here, the degree means the level of care an ordinary health care professional, with the same training and experience, would render in similar circumstances in the same community. This is the critical question in medical malpractice cases and if the answer is "no," and you suffered injury as a result of the poor treatment, you may file a suit for medical malpractice.
In the case of Dr. Laxman Balkrishna Joshi Vs. Dr. TrimbakBapu Godbole and Anr.[ 1969 AIR 128], the Supreme Court held that a doctor has certain aforesaid duties and a breach of any of those duties can make him liable for medical negligence. A doctor is required to exercise a reasonable degree of care that is set for this profession.
Dr. Kunal Saha vs Dr. Sukumar Mukherjee on 21 October, 2011 ( NC) original petition number 240 OF 1999 is one of the most important case regarding medical negligence. The brief facts of the case are-
Toxic Epidermal Necrolysis (TEN) is a rare and deadly disease. It is an extoliative dermatological disorder of (17) unknown cause. A patient with TEN loses epidermis in sheet-like fashion leaving extensive areas or denuded dermis that must be treated like a larze, superficial, partial-thickness burn wound. The incidence of TEN has been reported at 1 to 1.3 per million per year. The female-male ratio is 3:2. TEN accounts for nearly 1% of drug reactions that require hospitalization. TEN has a mortality rate of 25 to 70%.
Smt. Anuradha Saha (in short Anuradha), aged about 36 years wife of Dr. Kunal Saha (complainant) became the unfortunate victim of TEN when she alongwith the complainant was in India for a holiday during April-May 1998. She and the complainant although of Indian original were settled in the United States of America. The complainant is a doctor by profession and was engaged in research on HIV / AIDS for the past fifteen years. Anuradha after acquiring her Graduation and Masters Degree was pursuing a Ph.D. programme in a university of U.S.A. She was a Child Psychologist by profession. Anuradha showed certain symptoms of rashes over her body and received treatment at the hands of Opposite Parties and some other doctors as outdoor patient uptil 10.05.1998 and she was admitted in Advanced Medicare and Research Institute Limited, Calcutta (for short, AMRI), on 11.05.1998, where she was treated by the above-named Opposite Parties and other doctors uptil 16.05.1998. As there was no improvement in her condition, she was shifted to Breach Candy Hospital, Mumbai, on 17.05.1998 by an air ambulance. She was treated in Breach Candy Hospital from 17.05.1998 evening till she breathed her last on 28.05.1998.(18)
Our Complainant as husband of Anuradha felt that the doctors who treated Anuradha and the hospitals where she was treated were grossly negligent in her treatment and her death was occasioned due to gross negligence of the treating doctors and hospitals. Complainant, accordingly, got issued a legal notice to as many as 26 persons i.e. various doctors who treated Anuradha between end of April to the date of her death alleging negligence and deficiency in service on their part and claiming a total compensation exceeding Rs.55 crores from them. Complainant, thereafter filed the present complaint on 09.03.1999 before this Commission claiming a total compensation of Rs. Rs.77,07,45,000/- ( Seventy Seven Crores Seven Lakhs Fourty Five Thousand only). Later he also filed another complaint no. 179 of 2000 in this Commission against Breach Candy Hospital, its doctors and functionaries claiming a further compensation of Rs.25.30 crore ( though the said complaint was later on withdrawn), thereby making claim of compensation exceeding Rs.102 crores, perhaps the highest ever claimed by any complainant for medical negligence before any consumer fora established under the provisions of Consumer Protection Act, 1986 ( in short, the Act). These are some of the facts which make the present case extra ordinary.
The present complaint was filed by the complainant against the above-named opposite parties, namely, Dr. Sukumar Mukherjee, Dr. B. Haldar (Baidyanath Halder), Advanced Medicare and Research Institute Limited ( in short the AMRI Hospital ) and Dr. Balram Prasad and Dr.Abani Roy Chowdhury (physician) and Dr.KaushikNandy (plastic surgeon), the Directors of the AMRI Hospital and others (19) claiming a total compensation of Rs. Rs.77,07,45,000/- under different heads alleging various acts of commission and omission on the part of the doctors and hospital amounting to negligence and deficiency in service. Complainant through his brother-in-law Malay Kumar Ganguly also filed criminal complaint against some of the doctors and the hospital under section 304A IPC.
The complaint was resisted by the doctors and the hospital on a variety of grounds thereby denying any medical negligence or deficiency in service on their part. Parties led voluminous documentary and oral evidence and testimonies of some of the witness were even recorded through video conferencing through a Local Commissioner. After a protracted trial and hearing and on consideration of the evidence and material so produced on record and taking note of the legal position governing the question of medical negligence, this Commission ( by a three Member Bench presided over by the then President) dismissed the complaint by an order dated 01.06.2006 holding as under:
In the result, we reiterate that Doctors or Surgeons do not undertake that they will positively cure a patient. There may be occasions beyond the control of the medical practitioner to cure the patients. From the record, it would be difficult to arrive at the conclusion that the injection Depo-Medrol prescribed by Dr. Mukherjee was of such excessive dose that it would amount to deficiency in service by him which was his clinical assessment.
Thereafter, with regard to the alleged deficiency in the treatment given to Mrs. Anuradha by Opposite Party Doctors 2, 3, 5 and 6, there is no substance. The contention against the (20) hospital that it was not having Burns-Ward, and therefore, the deceased suffered is also without substance. Hence, this complaint is dismissed. There shall be no order as to costs.
Aggrieved by the dismissal of his complaint, the complainant filed Civil Appeal (No.1727 of 2007) in the Honble Supreme Court. It would appear that even before the said appeal was filed before the Honble Supreme Court, the Supreme Court was seized of the matter in Criminal Appeal Nos. 1191-94 of 2005 filed by Malay Kumar Ganguly, the complainant in the criminal complaint, against the Orders passed by the Calcutta High Court. Since the Criminal Appeals and the Civil Appeal filed by the complainant in the present complaint raised the same questions of fact and law, the Honble Supreme Court heard all the appeals together and decided the same by means of a detailed judgment dated 07.8.2009. By the said order, the Apex Court dismissed the Criminal Appeals filed by Shri Malay Kumar Ganguly but allowed the Civil Appeal No. 1727 of 2007 filed by the complainant and set aside the order dated 01.6.2006 passed by this Commission dismissing the complaint and remanded the matter to this Commission for the limited purpose of determining the adequate compensation, which the complainant is entitled to receive from the subsisting opposite parties by observing as under:
So far as the judgment of the Commission is concerned, it was clearly wrong in opining that there was no negligence on the part of the Hospital or the doctors. We, are, however, of the opinion, keeping in view the fact that Dr. Kaushik Nandy has done whatever was possible to be done and his line of treatment meets with the treatment protocol of one of (21) the experts viz. Prof. Jean Claude Roujeau although there may be otherwise difference of opinion, that he cannot be held to be guilty of negligence.
We remit the case back to the Commission only for the purpose of determination of the quantum of compensation.
We, keeping in view the stand taken and conduct of AMRI and Dr. Mukherjee, direct that costs of Rs.5,00,000 and Rs.1,00,000 would be payable by AMRI and Dr. Mukherjee respectively.
We further direct that if any foreign experts are to be examined it shall be done only through video conferencing and at the cost of the respondents.
Summary In view of the foregoing discussion, we conclude as under:
The facts of this case viz., residence of the complainant and Anuradha (deceased) in USA and they working for gain in that country; Anuradha having been a victim of a rare and deadly disease Toxic Epidermal Necrolysis (TEN) when she was in India during April-May 1998 and could not be cured of the said disease despite her treatment at two superspeciality medical centres of Kolkata and Mumbai and the huge claim of compensation exceeding Rs.77 crores made by the complainant for the medical negligence in the treatment of Anuradha makes the present case somewhat extraordinary.
The findings given and observations made by the Supreme Court in its judgment dated 07.08.2009 are absolutely binding on this Commission not only as ratio decidendi but also as as obiter dicta also, the judgment having been rendered by the Supreme Court in appeal against the (22) earlier order passed by a three Member Bench of this Commission and, therefore, no attempt can be allowed to read down / dilute the findings and observations made by the Supreme Court because the Supreme Court has remitted the complaint to this Commission only for the purpose of determination of the quantum of compensation after recording the finding of medical negligence against the opposite parties and others.
The task entrusted to the Commission may appear to be simple but the facts of the present case and the voluminous evidence led on behalf of the complainant has made it somewhat arduous. Still difficult was the task of apprortionment of the liability to pay the awarded amount by the different opposite parties and perhaps it was for this reason that the Supreme Court has remitted the matter to this Commission.
Multiplier method provided under the Motor Vehicles Act for calculating the compensation is the only proper and scientific method for determination of compensation even in the cases where death of the patient has been occasioned due to medical negligence / deficiency in service in the treatment of the patient, as there is no difference in legal theory between a patient dying through medical negligence and the victim dying in industrial or motor accident. The award of lumpsum compensation in cases of medical negligence has a great element of arbitrariness and subjectivity.
The foreign residence of the complainant or the patient and the income of the deceased patient in a foreign country are relevant factors but the compensation awarded by Indian Fora cannot be at par which are ordinarily granted by foreign (23) courts in such cases. Socio economic conditions prevalent in this country and that of the opposite parties / defendants are relevant and must be taken into consideration so as to modulate the relief. A complainant cannot be allowed to get undue enrichment by making a fortune out of a misfortune. The theoretical opinion / assessment made by a Foreign Expert as to the future income of a person and situation prevalent in that country cannot form a sound basis for determination of future income of such person and the Commission has to work out the income of the deceased having regard to her last income and future prospects in terms of the criteria laid down by the Supreme Court.
There exists no straight jacket formula for apportionment of the awarded compensation amongst various doctors and hospitals when there are so many actors who are responsible for negligence and the apportionment has to be made by evolving a criteria / formula which is just going by the nature and extent of medical negligence and deficiency in service established on the part of different doctors and hospitals.
On a consideration of the entirety of the facts and circumstances, evidence and material brought on record, we hold that overall compensation on account of pecuniary and non pecuniary damages works out to Rs.1,72,87,500/- in the present case, out of which we must deduct 10% amount on account of the contributory negligence / interference of the complainant in the treatment of Anuradha. That will make the net payable amount of compensation to Rs.1,55,58,750/- (rounded of to Rs.1,55,60,000/-). From this amount, we must further deduct a sum of Rs.25,93,000/- which was payable by (24) Dr. Abani Roy Chowdhury (deceased) or his Legal Representative as the complainant has forgone the claim against them.
In view of the peculiar facts and circumstances of the case and as a special case, we have awarded a sum of Rs. 5,00,000/- as cost of litigation in the present proceedings.
The above amount shall be paid by opposite parties no. 1 to 4 to the complainant in the following manner:
(i). Dr. Sukumar Mukherjee-opposite party no.1 shall pay a sum of Rs.40,40,000/- (Rupees Forty Lakh Forty Thousand only) i.e. [Rs.38,90,000/- towards compensation and Rs.1,50,000/- as cost of litigation] .
(ii) Dr. B. Haldar (Baidyanth Halder)-opposite party no.2 shall pay a sum of Rs.26,93,000/- (Rupees Twenty Six Lakh Ninety Three Thousand only) i.e. [Rs.25,93,000/- towards compensation and Rs.1,00,000/- as cost of litigation]
(iii) AMRI hospital-opposite party no.3 shall pay a sum of Rs.40,40,000/- (Rupees Forty Lakh Forty Thousand only ) i.e. [Rs.38,90,000/- towards compensation and Rs.1,50,000/- as cost of litigation]
(iv) Dr. Balram Prasad-opposite party no.4 shall pay a sum of Rs.26,93,000/- (Rupees Twenty Six Lakh Ninety Three Thousand only) i.e. [Rs.25,93,000/- towards compensation and Rs.1,00,000/- as cost of litigation] The opposite parties are directed to pay the aforesaid amounts to the complainant within a period of eight weeks from the date of this order, failing which the amount shall carry interest @ 12% p.a. w.e.f. the date of default.(25)
In the similar case, complaint no.32 of 2013, Smt. Sabiha Hamid vs. Dr. M. Khan Hospital Stadium Road, Bareilly, judgment dated 6.10.2021, decided by this bench in which a bundle of cotton was found in the abdomen of the patient which created continuous pain to her. When she was operated by the doctors of the SGPGI, the bundle of cotton was removed. It is clear that such negligence may cause septicemia or septic in the body and ultimately may cause death of the patient, if not treated in time.
The principle of res ipsa loquitor clearly applied in this case and the circumstances proved guilty and negligence of the doctor concerned.
I have seen the complaint in which the complainant has prayed Rs.12,50,000.00 as compensation in relation ot mental agony, economic loss, harassment and anxiety. The complainant has also prayed for the cost of the case.
In the case of Smt. Sabiha Hamid vs. Dr. M. Khan, case no.32 of 2013, this bench has ordered to pay Rs.50 lacs as compensation with interest @ 12% with other amounts for various charges. So, in my view in this case, the complainant is liable to get Rs.12,50,000.00 as compensation along within interest and also to get Rs.50,000.00 as cost of the case.
ORDER The complaint is allowed. The opposite parties are jointly and severally directed to pay Rs.12,50,000.00 with interest @10% p.a. from 21.5.2001 till the date of actual payment and the payment will be made within 30 days from the date of this judgment. If the amount is not paid within 30 days the rate of interest shall be 15% p.a. (26) The opposite parties are also jointly and severally directed to pay Rs. 50,000.00 as cost of the case with interest @10% p.a. from 21.5.2001 till the date of actual payment and the payment will be made within 30 days from the date of this judgment. If the amount is not paid within 30 days the rate of interest shall be 15% p.a. The stenographer is requested to upload this order on the Website of this Commission today itself.
Certified copy of this judgment be provided to the parties as per rules.
(Sushil Kumar) (Rajendra Singh) Member Presiding Member Judgment dated/typed signed by us and pronounced in the open court. Consign to record. (Sushil Kumar) (Rajendra Singh) Member Presiding Member Jafri, PA II Court 2 (सुरक्षित) परिवाद सं0- 88 /20 01 राकेश कुमार मिश्र बनाम डॉ0 आर0सी0 सिंह, एम0एस0 सर्जरी व अन्य दिनांक:- 26.08.2022 मा0 श्री विकास सक्सेना , सदस्य द्वारा उद्घोषित आदेश
परिवादी की ओर से विद्वान अधिवक्ता श्री सुशील कुमार शर्मा उपस्थित हैं। विपक्षी की ओर से विद्वान अधिवक्ता श्री एम0एच0 खान उपस्थित हैं।
मैंने उभयपक्ष के विद्वान अधिवक्तागण को सुना तथा पत्रावली का अवलोकन किया।
यह पत्रावली मुझ एकल पीठ के समक्ष पत्रावली में पारित निर्णय व आदेश दिनांकित 09.06.2022 पर आदेश में निहित प्रश्न पर मतभेद होने के कारण एकल पीठ को निर्दिष्ट किया गया है जिससे बहुमत राय के अनुसार राज्य उपभोक्ता आयोग की पीठ का आदेश निर्धारित किया जा सके। इस सम्बन्ध में वर्तमान परिवाद पर लागू उपभोक्ता संरक्षण अधिनियम, 1986 की धारा 16 उपधारा (1B)(iii) लागू होगी जिसके अनुसार यदि राज्य उपभोक्ता आयोग के किसी पीठ के सदस्यों द्वारा किसी आदेश में निहित किसी बिन्दु पर बराबर रूप से मतभेद होने पर यह प्रश्न पृथक राय हेतु एक सदस्य को सौंप दिया जायेगा तथा उक्त सदस्य की राय के अनुसार पीठ की बहुमत की राय निर्धारित की जायेगी। प्रस्तुत मामले में पीठासीन सदस्य माननीय श्री राजेन्द्र सिंह के साथ माननीय श्री सुशील कुमार, सदस्य महोदय की पीठ में पीठासीन सदस्य श्री राजेन्द्र सिंह द्वारा वाद को आज्ञप्त करते हुए विपक्षीगण को संयुक्त एवं पृथक रूप से 12,50,000/-रू0 मय 10 प्रतिशत वार्षिक ब्याज दि0 21.05.2001 से वास्तविक अदायगी तक दिए जाने के आदेश पारित किए गए एवं यह शर्त लगाई गई कि 30 दिन के भीतर उक्त धनराशि न दिए जाने पर 10 प्रतिशत के स्थान पर 15 प्रतिशत वार्षिक ब्याज इस धनराशि पर देना होगा। इसके अतिरिक्त विपक्षीगण को वाद व्यय हेतु रू0 50,000/- मय 10 प्रतिशत वार्षिक ब्याज दिलाये जाने के आदेश भी पारित किए गए।
पीठ के सदस्य महोदय श्री सुशील कुमार द्वारा भी परिवाद को आज्ञप्त किया गया, किन्तु मूल आदेश में परिवादी को रू0 5,00,000/- क्षतिपूर्ति 03 माह के अन्दर दिलाये जाने के आदेश दिए गए, जिस पर परिवाद प्रस्तुत करने की तिथि से वास्तविक अदायगी तक 06 प्रतिशत वार्षिक साधारण ब्याज भी दिलाये जाने के आदेश दिए गए एवं वाद व्यय के रूप में रू0 10,000/- दिलाये जाने के आदेश पारित किए गए।
इस प्रकार दोनों सदस्यगण के मध्य वाद के गुण-दोष पर कोई मतभेद नहीं आया। दोनों मा0 सदस्यगण ने वाद को आज्ञप्त किया जाना उचित माना है।
इस मामले में उपभोक्ता संरक्षण अधिनियम, 1986 के प्रावधान लागू होंगे, क्योंकि यह परिवाद वर्ष 2001 में योजित किया गया है। अधिनियम की धारा 16 उपधारा (1B)(iii) के अनुसार यदि किसी पीठ के सदस्य किसी बिन्दु पर मतभेद रखते हैं तो मा0 अध्यक्ष, महोदय द्वारा मामले को किसी अन्य सदस्य को संदर्भित कर देना होगा जो उन बिन्दुओं पर सुनकर अपना निष्कर्ष देंगे जिस पर पीठ के सदस्यों का मतभेद है। अधिनियम के उक्त प्रावधान को अवलोकित करते हुए इस मामले में मुझे एकल सदस्य पीठ को केवल दोनों आदरणीय सदस्यगण द्वारा क्षतिपूर्ति की धनराशि के सम्बन्ध में ही निष्कर्ष दिया जाना है। वाद के गुण-दोष पर इस एकल पीठ का कोई निष्कर्ष नहीं आना है, क्योंकि गुण-दोष पर सदस्यगण में कोई मतभेद नहीं है।
जहां तक उपभोक्ता को दिए जाने वाली क्षतिपूर्ति का प्रश्न है यह पीठ (सदस्यगण) के विवेकाधिकार पर निर्भर करती है कि वह तथ्य एवं परिस्थितियों को अवलोकित करते हुए कितनी धनराशि इस मामले में उचित पाती है। चूँकि पीठ के सदस्यगण में मतभेद है। अत: मा0 सर्वोच्च न्यायालय एवं मा0 राष्ट्रीय आयोग द्वारा समान तथ्यों के मामले में दिए गए क्षतिपूर्ति का अवलोकन किया जाना आवश्यक है। अच्युत राव हरिभाऊ खोदवा तथा अन्य बनाम स्टेट आफ महाराष्ट्रा व अन्य प्रकाशित IV(2006)C.P.J. पृष्ठ 8(S.C.) के वाद में मा0 सर्वोच्च न्यायालय के समक्ष इसी तरह के मामले में चिकित्सीय उपेक्षा में चिकित्सक महोदय ने प्रसूति सम्बन्ध में गर्भ निरोध शल्य क्रिया करते समय एक तौलिया का टुकड़ा मरीज के शरीर में छोड़ दिया था जिस कारण उसकी मृत्यु हो गई। सिविल न्यायालय ने इस मामले में रू0 36,000/- की क्षतिपूर्ति का आदेश दिया जो माननीय सर्वोच्च न्यायालय द्वारा उचित माना गया।
यह निर्णय वर्ष 2006 का है एवं इस एकल पीठ के समक्ष निर्णय वर्ष 2022 में पारित किया गया है। अत: मुद्रास्फीति एवं तत्कालीन धनराशि की तुलना समय के अनुसार की जानी है। वेबसाइट इंफ्लेशन टूल.Com CPI में वर्ष 2006 एवं वर्ष 2022 में मुद्रास्फीति एवं धनराशि का अवमूल्यन इस प्रकार निर्धारित किया गया है कि वर्ष 2006 में 100/-रू0 का मूल्य वर्तमान में लगभग 400/-रू0 हो गया है। इस प्रकार यह धनराशि लगभग 1,50,000/-रू0 आती है जो समान मामले में मा0 सर्वोच्च न्यायालय द्वारा उचित पायी गई।
मा0 राष्ट्रीय आयोग द्वारा पारित एक अन्य निर्णय ज्योति देवी बनाम सुकेत हॉस्पिटल व अन्य प्रकाशित II(2016)CPJ पेज 109 (N.C.) में भी मरीज ज्योति देवी के शरीर में तौलिए का टुकड़ा शल्य क्रिया के समय छोड़ दिया गया। इस प्रकार चिकित्सीय लापरवाही से ज्योति देवी को शारीरिक व मानसिक एवं आर्थिक हानि उठानी पड़ी। मा0 राष्ट्रीय आयोग ने इस मामले में रू0 2,00,000/- की धनराशि क्षतिपूर्ति के रूप में दिलवाया जाना उचित माना। यह निर्णय वर्ष 2016 का है। इस मामले में भी वर्ष 2016 से वर्ष 2022 के मध्य मुद्रास्फीति एवं धनीय अवमूल्यन को दृष्टिगत किया जाना आवश्यक है। पुन: वेबसाइट इंफ्लेशन टूल.Com तथा ब्यूरो आफ लेबर स्ट्रैटस्टिक के अनुसार वर्ष 2016 में 100/-रू0 की धनराशि का मूल्य वर्ष 2022 में 2.4 गुना हो गया है। इस प्रकार मा0 राष्ट्रीय आयोग द्वारा प्रदान की गई धनराशि रू0 2,00,000/- वर्तमान में रू0 4,80,000/- के समान होगी।
पीठ के समक्ष मामले में परिवादी द्वारा अपने परिवाद पत्र में उक्त चिकित्सीय उपेक्षा से होने वाली हानि को परिवाद के प्रस्तर 18 से 21 में दर्शाया गया है जिसमें यह कहा गया है कि परिवादी की आंत का ऑपरेशन करके आंत को छोटी करना पड़ा तथा लापरवाही के कारण अब तक अत्यंत शारीरिक व मानसिक क्षति हुई है। परिवादी पूर्ण रूप से स्वस्थ नहीं हो रहा है। मजबूरन विभागीय अवकाश पर है तथा परिवादी काफी कमजोर हो गया है। इस प्रकार परिवादी ने जो हानियां चिकित्सीय उपेक्षा के कारण दर्शायी है वह मा0 सर्वोच्च न्यायालय द्वारा दिए गए निर्णय जिसमें मरीज की मृत्यु हो गई एवं मा0 राष्ट्रीय आयोग द्वारा दिए गए निर्णय के मामले में मरीज को होने वाले कष्ट से अधिक प्रतीत नहीं होती है। अत: इन परिस्थितियों को देखते हुए आदरणीय सदस्य श्री सुशील कुमार द्वारा जो धनराशि 5,00,000/-रू0 निर्धारित की गई है वह उचित प्रतीत होती है।
पीठ के आदरणीय सदस्य के मध्य धनराशि पर दिए जाने वाले ब्याज की दर पर भी मतभेद है। इस सम्बन्ध में ब्याज अधिनियम, 1978 की धारा 3 प्रदान करती है कि-
Power of court to allow interest.Previous Next "In any proceedings for the recovery of any debt or damages or in any proceedings in which a claim for interest in respect of any debt or damages already paid is made, the court may, if it thinks fit, allow interest to the person entitled to the debt or damages or to the person making such claim, as the case may be, at a rate not exceeding the current rate of interest, for the whole or part of the following period, that is to say"
a. ...........................................................................
b.............................................................................
इसी अधिनियम की धारा 1(b) में वर्तमान प्रचलित ब्याज (Current rate of Interest) को निम्नलिखित प्रकार से परिभाषित किया गया:-
"current rate of interest" means the highest of the maximum rates at which interest may be paid on different classes of deposits (other than those maintained in savings account or those maintained by charitable or religious institutions) by different classes of scheduled banks in accordance with the directions given or issued to banking companies generally by the Reserve Bank of India under the Banking Regulation Act, 1949 (10 of 1949)."
वर्तमान प्रचलित दर जो रिजर्व बैंक आफ इंडिया द्वारा अनुसूचित बैंकों को सावधि जमा हेतु दी गई है वह लगभग 07 प्रतिशत है। अत: इसको दृष्टिगत करते हुए 06 प्रतिशत प्रतिवर्ष की दर ब्याज उचित प्रतीत होती है जो सदस्य श्री सुशील कुमार द्वारा ब्याज की दर नियत की गई है। इस प्रकार उपरोक्त विवेचना के आधार पर एकल पीठ के रूप में मैं सदस्य के रूप में श्री सुशील कुमार, सदस्य के मतभेद के बिन्दु पर निष्कर्ष से सहमत हूँ।
आशुलिपिक से अपेक्षा की जाती है कि वह इस आदेश को आयोग की वेबसाइट पर नियमानुसार यथाशीघ्र अपलोड कर दें।
(विकास सक्सेना) सदस्य शेर सिंह, आशु0, कोर्ट नं0- 2 [HON'BLE MR. Rajendra Singh] PRESIDING MEMBER [HON'BLE MR. SUSHIL KUMAR] JUDICIAL MEMBER